NPIMap

Individual provider Active NPI

Brian Neubauer, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1053957829
Registry record updated Jan 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061217 Issued in PA
Practice address
3401 N. Broad Street
6TH Floor, Zone B, Orthopedics
Philadelphia, PA 19140-5103
Phone
(215) 707-2111
NPI assigned
Nov 26, 2019
Last updated
Jan 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA061217 PA Primary

Addresses

Primary practice location

3401 N. Broad Street
6TH Floor, Zone B, Orthopedics
Philadelphia, PA 19140-5103

Mailing address

3401 N Broad St FL 6
Philadelphia, PA 19140-5103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200203000696 PA Practitioner - Physician Assistant 6709212160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Jefferson Medical College of Thomas Jefferson University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

333 Cottman Ave
Philadelphia, PA 19111-2434
Phone (844) 570-1767

3401 N Broad St
Philadelphia, PA 19140-5103

7600 Central Ave
Philadelphia, PA 19111-2442
Phone (215) 707-5864

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA061217PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan, Inc CurrentSince Nov 26, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Nov 26, 2019 Accepting new patients

Locations

2450 W Hunting Park Ave
Philadelphia, PA 19129
Phone (215) 707-2433

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3401 N Broad St
Fl 6
Philadelphia, PA 19140
Phone (215) 707-3185

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578182400000",
    "number": "1053957829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST FL 6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N. BROAD STREET",
            "address_2": "6TH FLOOR, ZONE B, ORTHOPEDICS",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUBAUER",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2020-01-05",
        "certification_date": "2020-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.